MALDI-TOF MS Based Proteomic Fingerprinting of Total Serum Plasma for Somatic Pain Syndromes

There are racial and ethnic disparities regarding pain management within the United States, and that disproportionately affects women of color. There is also a fundamental lack of information regarding the biological mechanism by which pain sensitization and perception occurs, and how it could be affected by both neurologic and somatic pain syndromes. Methods: Research was performed on principal electronic scientific databases including Google Scholar, PubMed, and Embase with search terms “MALDI-TOF”, “ESI-MS”, “Pain”, and “Biomarkers”, as well as other modifiers to narrow the literature search. Results: Studies on comparison between MALDI-TOF and other traditional analysis platforms, including Electrospray Ionization (ESI-MS), proteomic characterization of biomarkers related to pain, classification of disease states based on global analysis of spectrograms, disparities between racial and ethnic groups regarding pain medication prescription, workflow pipelines regarding biomarker isolation and characterization, and potential biomarkers specific to somatic and neurologic pain symptoms (Cancer, Psychiatric Sensitization, Osteoarthritis, Fibromyalgia) and general inflammation have been presented and commented on. Conclusion: This overview supports the view that MALDI-TOF has demonstrated high utility in detecting, selecting, and characterizing biomarkers relating to pain symptoms and pain-inducing conditions, compared to more traditional methods, with greater sequence coverage during proteomic analysis, specificity, and sensitivity. Additionally, the MALDI-TOF platform can be used both clinically and experimentally to describe the biomolecular basis of disease progression. This platform can be used clinically as an objective measure of pain and pain sensation to guide clinical treatment and reduce medical care inequality for marginalized groups and individuals

The Correlation Between Serum C-Reactive Protein Level and Risk of Future Cardiovascular Disease: A Neurodivergent Population Dilemma

Extensive research on neurotypical (NT) populations has demonstrated that a chronically elevated level of serum C Reactive Protein (CRP) is a strong predictor of future cardiovascular disease (CVD). Interestingly, many neurodivergent (ND) populations experience chronically elevated CRP levels higher than NT controls. Current research is concerned with establishing the significance of this relationship to accurately predict CVD risk for potentially at risk ND patients. To contribute to this gap in knowledge, the Rowan-Virtua Regional Integrated Special Needs (RISN) Center patient population will be studied to identify trends in baseline serum CRP levels across a multitude of ND conditions. A clinical risk assessment scale, specifically designed for treating ND populations, will be developed based on the significance of the results of this study

Addressing the Black Maternal Mortality Rate

Introduction: As of 2021, the Black maternal mortality rate in the United States was 69.9 deaths per 100,000 live births as compared to the national average of 32.9 and the White American average of 26.61. It has been demonstrated that this discrepancy is not fully explained by socioeconomic status. Doulas are professionals who provide support and guidance throughout pregnancy, birth, and early parenthood. Encouraging the use of doulas may be an effective approach to improve the birth experience for Black mothers. Methods: A literature review was performed using PubMed and the following search strings: maternal mortality rate (+race, +race +ethnicity, +African Americans, +Doulas) and improving perinatal care (+race, +doulas). In addition to this search strategy, title and abstract searches were used. Systematic and narrative reviews, qualitative and quantitative primary publications were included. Publicly-available data from national organizations were also used. Extracted data were analyzed through IBM SPSS v29.0, GraphPad Prism v12.0 and/or functions in Excel for quantitative analyses. Thematic word searches were used for qualitative analyses. Results: Women supported by doulas are found to experience more respectful care, as opposed to women without doulas. This association is largest for non-Hispanic Black women. Doulas were found to positively impact perinatal outcomes during antepartum, labor and delivery, and postpartum periods. These impacts include: improved self-esteem, increased perceived social and clinical support, decreased cesarean rates, decreased rates of preterm birth and low birthweight, and increased infant safety practices. Conclusions: The support of doulas is associated with both objective and subjective improvements in birth outcomes, particularly for Black mothers. Surveys indicated that Black mothers benefited not only from their experience with doulas, but from the support they gained throughout their pregnancies and deliveries. This suggests that increased use of doulas by Black mothers may help address the racial disparities in maternal mortality and birth outcomes

Investigating the Link Between Preeclampsia/Eclampsia in Mothers and Cardiovascular Risk Among Their Neurodivergent Children

Preeclampsia/Eclampsia are common gestational conditions among pregnant women. These individuals have hypertension after 20 weeks of gestation, proteinuria/end-stage organ disease, and may have seizures. These conditions can put the mother and fetus at risk.1,2 A review of literature investigates whether an association exists between congenital heart defects (CHD), and maternal preeclampsia/eclampsia in the neurotypical and neurodivergent population. The Rowan-Virtua Regional Integrated Special Needs (RISN) Center patient population was used to investigate whether maternal preeclampsia/eclampsia is indicative of higher congenital heart disease (CHD) in their neurodivergent children to achieve better quality of care. As a first step towards exploring the relationship between preeclampsia/eclampsia and CHD in the neurodivergent population, the current literature was reviewed. Retrospective Chart Reviews were also conducted. Preliminary data indicates that common congenital cardiac anomalies among the neurodivergent population whose mothers experienced preeclampsia/eclampsia are Tetralogy of Fallot, Bicuspid Aortic Valve, Atrial Septal Defect, Ventricular Septal Defect, and Pulmonic Stenosis. More studies need to be done on the neurodivergent population to determine whether a strong association exists between congenital cardiovascular anomalies and maternal preeclampsia/eclampsia

Inflammatory Marker Levels among Patients Diagnosed with Autism Spectrum Disorder and Congenital Heart Defects

Autism Spectrum Disorder (ASD) and congenital heart defects (CHD) are conditions that both confer an immense increase in standard of care, and utilization of medical resources addressing comorbidities. One shared symptom that has been consistently cited is inflammation. This review sought to explore the levels of Tumor Necrosis Factor- (TNF-) and Interleukin-6 (IL-6) between patients diagnosed as having either ASD or CHD. By compiling published data containing the mean values of these two inflammatory markers within these populations, it was shown that while both have significantly elevated levels compared to a phenotypically normal demographic, there is no significant difference between IL-6 levels in ASD vs. CHD patients. However, there are significantly higher levels of TNF- in CHD patients compared to ASD patients. Understanding the relationship of inflammatory markers would help guide better treatments and outcomes in ASD population, especially to those with CHD

Physical Medicine & Rehabilitation Referrals in Cancer Patients

Physical Medicine and Rehabilitation (PM&R) can address functional limitations in various conditions, including cancer. Cancer rehabilitation aims to address functional impairments resulting from both the disease itself and its treatments, striving to optimize physical, social, psychological, and vocational functioning. Existing literature indicates that PM&R services significantly benefit cancer patients by improving their overall quality of life. Studies have found that optimal utilization of PM&R services can increase the Functional Independence Measure (FIM) in cancer patients. Current National Comprehensive Cancer Network and American Cancer Society guidelines emphasize the importance of incorporating PM&R services into oncology care to enhance the function and quality of life of cancer survivors. A literature review revealed that more than 60% of cancer patients experience functional morbidity, but only 2.9% are referred to PM&R services. This underutilization of PM&R services is found in other surveys and presents as a multifactorial problem that needs to be addressed to improve patient outcomes and quality of life. Factors that contribute to underutilization of these services include lack of patient or physician awareness of the benefits of PM&R, limited resources, patient adherence, patient prognosis, and socioeconomic status. A survey was created to further understand referral patterns to PM&R services among oncologists. The results from the questionnaire will help identify effective interventions needed within the community to better address the issue

Is There an Association Between Preeclampsia/Eclampsia and Congenital Heart Disease Among the Neurodivergent Population?

Preeclampsia and eclampsia are very common gestational conditions among pregnant individuals worldwide. These individuals are diagnosed with high blood pressure (after 20 weeks of gestation), proteinuria/end-stage organ disease, and may include seizures. These conditions can put the mother and fetus at risk. A review of literature has shown that there is an association between cardiovascular defects among the neurodivergent population, where these individuals have a higher risk of developing atrial septal defects and ventricular septal defects. The Rowan-Virtua Integrated Special Needs (RISN) Center patient population will be used to investigate whether preeclampsia/eclampsia in mothers is indicative of higher congenital heart disease (CHD) in their neurodivergent children to achieve better quality of care. As a first step towards exploring the relationship between preeclampsia/eclampsia and CHD in the neurodivergent population, the current literature was reviewed. The results and the emergent future plan of research are presented

Neurocalcin δ Modulation of ROS-GC1, a New Model of Ca2+ Signaling†

ROS-GC1 membrane guanylate cyclase is a Ca(2+) bimodal signal transduction switch. It is turned off by a rise in free Ca(2+) from nanomolar to the semicromolar range in the photoreceptor outer segments and the olfactory bulb neurons; by a similar rise in the bipolar and ganglion retinal neurons it is turned on . These opposite operational modes of the switch are specified by its Ca(2+) sensing devices, respectively termed GCAPs and CD-GCAPs. Neurocalcin delta is a CD-GCAP. In the present study, the neurocalcin delta-modulated site, V(837)-L(858), in ROS-GC1 has been mapped. The location and properties of this site are unique. It resides within the core domain of the catalytic module and does not require the alpha-helical dimerization domain structural element (amino acids 767-811) for activating the catalytic module. Contrary to the current beliefs, the catalytic module is intrinsically active; it is directly regulated by the neurocalcin delta-modulated Ca(2+) signal and is dimeric in nature. A fold recognition based model of the catalytic domain of ROS-GC1 was built, and neurocalcin delta docking simulations were carried out to define the three-dimensional features of the interacting domains of the two molecules. These findings define a new transduction model for the Ca(2+) signaling of ROS-GC1

Gestational Diabetes Among the South Asian Diaspora in the United States of America: A Scoping Review

Aim: The scoping review was conducted to review the current knowledge base regarding gestational diabetes mellitus (GDM) among South Asians in the United States. In addition, the review was meant to identify any gaps in knowledge, specifically about the current care received by South Asians as well as the associated adverse health outcomes. Methods: A systematic search of PubMed, Web of Science, Embase, and Scopus was conducted. Key words gestational diabetes South Asians in the United States were used as search terms. Search was restricted to U.S. articles published on or after 01/01/2013 with key words. Articles were screened by 3 reviewers (AD, MS, and GA) at both the title/abstract level and at the full text level. One reviewer (RU) extracted data from the included articles and analyzed them descriptively to map the results. Results: Data from included articles was categorized as pertaining to prevalence, risk factors, or outcomes. Prevalence: South Asian women were found to have a statistically significant higher risk of having GDM compared to Non-Hispanic Caucasian women in the United States (p\u3c0.0001). South Asian women living in ethnic enclaves also had higher chances of having GDM compared to those living in other neighborhoods (95% CI). Risk Factors: Among the risk factors associated with GDM, inadequate health insurance and late initiation of prenatal care were highest among Pakistani and Bangladeshi women (p \u3c0.001). Outcomes: South Asian women with a previous history of GDM were found to have a three-fold increase in risk of developing Type 2 Diabetes compared to their non-GDM counterparts (95% CI). Pakistani women with GDM were implicated to have significantly higher odds of having infants that were Smaller for Gestational Age within the 10th percentile compared to Non-Hispanic Caucasian women, whereas Indian and Bangladeshi women had two times the odds of having a child Small for Gestational Age in the 5th percentile compared to Non-Hispanic Caucasian women. Conclusions: Though research supports that South Asian women have the greatest risk of developing GDM compared to any other ethnic group, research is limited on what factors contribute to this disparity and adverse outcomes associated with GDM within the population. GDM in South Asian women in the United States is associated with lower birth weights and a higher incidence of Type 2 diabetes, highlighting the need to develop protocols for healthcare providers to improve healthcare for this population and improve healthcare outcomes

Community Healthcare Workers (CHW) High-Risk Stabilization Study: Does the Ability of CHWs at Mobile COVID Clinics to Link patients with Uncontrolled Diabetes to a Physician Improve Short Term Outcomes?

Uncontrolled diabetes may cause preventable but significant effects. One major preventative measure is early screening; there are hopes that community healthcare workers can increase awareness and screening availability, especially in underserved populations. We hosted and recorded logs of patients at mobile COVID health clinics, educating those with uncontrolled diabetes and connecting them to healthcare. We then looked to see if any patients had improvements in blood glucose to non-diabetic levels. 378 patients were logged, but only 138 were in events that had a significant amount of repeat visits. Twenty-five of them had blood sugar indicative of uncontrolled diabetes. Out of those, there were six patients with uncontrolled diabetes and multiple visits. Four of them had improvements in blood glucose on their most recent visit, with two maintaining persistently high levels of blood glucose. While these preliminary studies show promise in the potential efficacy of CHWs in improving screening and outcomes of uncontrolled diabetes, there is a very limited sample size. Future studies should incorporate more patient logs and explore other chronic conditions commonly undiagnosed in underserved populations such as chronic kidney disease and hypertension